Portuguese Lifeguards Performance in Aquatic Rescue: An Exploratory Study

The objective of the study was to compare the performance of Portuguese lifeguards in two trials of simulated rescue at the beach within a regular continuous workday. Additionally, the study aimed to analyse the influence of experience and initial course syllabus on the rescue performance. A total of 86 Portuguese lifeguards (LG) participated in this study, 69 males and 17 females. The two simulated drowning occurrences were planned to occur at 50 meters from the coastline between 9.00h am and 18.00h pm. The weather conditions, the characteristics of the beach, wave amplitude were also controlled. The results were analysed through descriptive and comparative tests and pairwise comparisons. The rescue was performed in less than 6 minutes by 91.9% of the subjects, 5.8% between and 6-10 min and only 2.3% exceeded 10 minutes. No significant differences (p\u3e0.05) were found on the total rescue time between trials and the number of ventilations. The number of training sessions at the beach during the lifesaving course was negatively correlated with a faster rescue trial (r= -0.218; p=0.004). The majority of the Portuguese LG in this study demonstrated the readiness required to conduct a full rescue in less than 6 minutes. O objetivo do estudo foi comparar o desempenho dos nadadores-salvadores (NS) portugueses em dois ensaios de resgate simulado na praia em um dia de trabalho contínuo e regular. Além disso, o estudo teve como objetivo analisar a influência da experiência e do currículo inicial do curso no desempenho do resgate. Um total de 86 NS portugueses participaram neste estudo, 69 homens e 17 mulheres. As duas ocorrências simuladas de afogamento foram planeadas para ocorrer a 50 metros da costa, entre 9h e 18h. As condições climáticas, as características da praia, a amplitude das ondas também foram controladas. Os resultados foram analisados através de testes descritivos e comparativos e comparações aos pares. O resgate foi realizado em menos de 6 minutos por 91,9% dos sujeitos, 5,8% entre 6 e 10 minutos e apenas 2,3% excederam os 10 minutos. Não foram encontradas diferenças significativas (p\u3e 0,05) no tempo total de resgate entre os ensaios e o número de ventilações. O número de sessões de treino na praia durante o curso de nadador-salvador foi correlacionado com um teste de resgate mais rápido (r = -0, 218; p = 0,004). A maioria dos NS portugueses neste estudo demonstrou a prontidão necessária para realizar um resgate completo em menos de 6 minutos

The association of the step duration in an incremental protocol in the rower ergometer and the maximal lactate steady state intensity

This study aims to analyse which are better step duration related to the maximum lactate steady-state test (MLSS) intensity and the intensity equivalent to the accumulation of 4mmol/L lactate (AnT4) determined through an incremental protocol using a rowing ergometer, using different steps durations (step3min, step5min, step7min). Ten elite Portuguese rowers (25.1 ± 4.82 years; 177.5 ± 5.50 cm; 69.8 ± 2.74 kg) performed rowing ergometer protocols to determine the maximum lactate steady state (MLSS). Subsequently, incremental tests were realised to determine AnT4, using different step durations (step3min, step5min, step7min). The results showed a strong correlation between MLSS and AnT4 (r>0.90; p<0.001) obtained AnT different steps (step3min, step5min, step7min). However, the determined intensity equivalent to 4mmol/L obtained with different step durations that showed the highest correlation with MLSS (246.5 ± 35.20W) was verified in the protocol of 7minute steps (251.5 ± 35,72W). The present study indicates that the use of 7 minutes steps is the most appropriate for determining the AnT4 intensity related to the aerobic component of a high-performance rowing athlete

Surviving rectal cancer at the cost of a colostomy: global survey of long-term health-related quality of life in 10 countries

Background Colorectal cancer management may require an ostomy formation; however, a stoma may negatively impact health-related quality of life (HRQoL). This study aimed to compare generic and stoma-specific HRQoL in patients with a permanent colostomy after rectal cancer across different countries. Method A cross-sectional cohorts of patients with a colostomy after rectal cancer in Denmark, Sweden, Spain, the Netherlands, China, Portugal, Australia, Lithuania, Egypt, and Israel were invited to complete questionnaires regarding demographic and socioeconomic factors along with the Colostomy Impact (CI) score, European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ-C30) and five anchor questions assessing colostomy impact on HRQoL. The background characteristics of the cohorts from each country were compared and generic HRQoL was measured with the EORTC QLQ-C30 presented for the total cohort. Results were compared with normative data of reference European populations. The predictors of reduced HRQoL were investigated by multivariable logistic regression, including demographic and socioeconomic factors and stoma-related problems. Results A total of 2557 patients were included. Response rates varied between 51-93 per cent. Mean time from stoma creation was 2.5-6.2 (range 1.1-39.2) years. A total of 25.8 per cent of patients reported that their colostomy impairs their HRQoL 'some'/'a lot'. This group had significantly unfavourable scores across all EORTC subscales compared with patients reporting 'no'/'a little' impaired HRQoL. Generic HRQoL differed significantly between countries, but resembled the HRQoL of reference populations. Multivariable logistic regression showed that stoma dysfunction, including high CI score (OR 3.32), financial burden from the stoma (OR 1.98), unemployment (OR 2.74), being single/widowed (OR 1.35) and young age (OR 1.01 per year) predicted reduced stoma-related HRQoL. Conclusion Overall HRQoL is preserved in patients with a colostomy after rectal cancer, but a quarter of the patients interviewed reported impaired HRQoL. Differences among several countries were reported and socioeconomic factors correlated with reduced quality of life. In this global survey among 2557 individuals with a colostomy after rectal cancer, generic and stoma-specific HRQoL differed significantly between countries; however, it resembled that of country-specific population norms. The most important predictors of stoma-related reduced HRQoL were stoma dysfunction and being financially burdened by the colostomy

Concepção de uma base de dados do cancro colorretal

Dissertação de mestrado em Gestão e Economia da Saúde, apresentada à Faculdade de Economia da Universidade de Coimbra, sob a orientação de Vitor Manuel Reis Raposo e João Manuel de Paiva Pimentel

A importância das bases de dados na gestão do conhecimento em saúde

Os autores refletem sobre a importância da gestão da informação como meio de promoção do conhecimento na saúde, tomando como exemplo o cancro colorretal em Portugal. Apresentam os principais registos de medição dos resultados do tratamento do cancro colorretal nacionais e europeus e tecem algumas considerações sobre gestão do conhecimento e o processo de tomada de decisão em saúde. Terminam com a descrição do projeto de modelação desenvolvido para o cancro colorretal

Validação da versão em português do escore da síndrome da ressecção anterior baixa

Objective: The authorsaimtoperformathoroughtranslationwithculturaladaptationof the patientreportedoutcometool,LowAnteriorResectionSyndrome(LARS)Score,tothe Portugueselanguage(LARS-PT)inthePortuguesepopulationwithrectalcancer,afterproc- tectomywithanastomosis. Methods: Accordingtothecurrentinternationalrecommendations,wedesignedthisstudy encompassing threemainphases:(i)culturalandlinguisticvalidationtoEuropeanPor- tuguese; (ii)feasibilityandreliabilitytestsoftheversionobtainedinthepreviousphase; and (iii)validityteststoproduceafinalversion.Thequestionnairewascompletedby154 patients fromsixPortugueseColorectalCancerUnits,and58completedittwice. Results: PortugueseversionofLARSscoreshowedhighconstructvalidity.Regardingthetest- retest,theglobalIntraclassCorrelationshowedverystrongtest-retestreliability.Lookingat all fiveitems,onlyitems3and5presentamoderatecorrelation.LARSscorewasableto discriminate symptomsshowingworsequalityoflife,inpatientssubmittedtopreoperative radioandchemotherapy. Conclusions: LARS questionnairehasbeenproperlytranslatedintoEuropeanPortuguese, demonstratinghighconstructvalidityandreliability.Thisisaprecise,reproducible,simple, clear anduser-friendlytoolforevaluatingbowelfunctioninrectalcancerpatientsafter sphincter savingoperation.Objetivo: Os autorespretendemfazerumatraduc¸ãominuciosaeculturalmenteadaptada paraalínguaportuguesadoescoredaSíndromedeRessecc¸ãoAnteriorBaixa(Low Ante- rior ResectionSyndrome [LARS]), uminstrumentodedesfechorelatadopelopaciente,na populac¸ãoportuguesacomcâncerretalapósproctectomiacomanastomose. Métodos: De acordocomasrecomendac¸õesinternacionaisatuais,oestudofoiproje- tado abrangendotrêsfasesprincipais:(i)validac¸ãoculturalelinguísticaparaoportuguês europeu;(ii)testesdeviabilidadeeconfiabilidadedaversãoobtidanafaseanterior;e(iii) testes devalidadeparaproduziraversãofinal.Oquestionáriofoipreenchidopor154 pacientes deseisunidadesportuguesasdecâncercolorretale58pacientescompletaram duas vezes. Resultados: A versãoemportuguêsdoescoreLARSmostroualtavalidadedeconstruto. A correlac¸ãointra-classeglobalapresentouconfiabilidademuitofortenoteste-reteste. Considerando-setodososcincoitens,apenasositens 3 e 5 apresentam umacorrelac¸ão moderada.OescoreLARSfoicapazdediscriminarsintomascompiorqualidadedevidaem pacientes submetidosaradio-equimioterapiapré-operatória. Conclusões: O questionárioLARSfoitraduzidocorretamenteparaoportuguêseuropeu, demonstrandoaltavalidadedeconstrutoeconfiabilidade.Trata-sedeumaferramentapre- cisa, reproduzível,simples,claraefácildeusarparaavaliarafunc¸ãointestinalempacientes com câncerretalapósoperac¸õespoupandooesfíncter

Validation of Portuguese version of the low anterior resection syndrome score

Objective: The authors aim to perform a thorough translation with cultural adaptation of the patient reported outcome tool, Low Anterior Resection Syndrome (LARS) Score, to the Portuguese language (LARS-PT) in the Portuguese population with rectal cancer, after proctectomy with anastomosis. Methods: According to the current international recommendations, we designed this study encompassing three main phases: (i) cultural and linguistic validation to European Portuguese; (ii) feasibility and reliability tests of the version obtained in the previous phase; and (iii) validity tests to produce a final version. The questionnaire was completed by 154 patients from six Portuguese Colorectal Cancer Units, and 58 completed it twice. Results: Portuguese version of LARS score showed high construct validity. Regarding the test-retest, the global Intraclass Correlation showed very strong test-retest reliability. Looking at all five items, only items 3 and 5 present a moderate correlation. LARS score was able to discriminate symptoms showing worse quality of life, in patients submitted to preoperative radio and chemotherapy. Conclusions: LARS questionnaire has been properly translated into European Portuguese, demonstrating high construct validity and reliability. This is a precise, reproducible, simple, clear and user-friendly tool for evaluating bowel function in rectal cancer patients after sphincter saving operation. Resumo: Objetivo: Os autores pretendem fazer uma tradução minuciosa e culturalmente adaptada para a língua portuguesa do escore da Síndrome de Ressecção Anterior Baixa (Low Anterior Resection Syndrome [LARS]), um instrumento de desfecho relatado pelo paciente, na população portuguesa com câncer retal após proctectomia com anastomose. Métodos: De acordo com as recomendações internacionais atuais, o estudo foi projetado abrangendo três fases principais: (i) validação cultural e linguística para o português europeu; (ii) testes de viabilidade e confiabilidade da versão obtida na fase anterior; e (iii) testes de validade para produzir a versão final. O questionário foi preenchido por 154 pacientes de seis unidades portuguesas de câncer colorretal e 58 pacientes completaram duas vezes. Resultados: A versão em português do escore LARS mostrou alta validade de construto. A correlação intra-classe global apresentou confiabilidade muito forte no teste-reteste. Considerando-se todos os cinco itens, apenas os itens 3 e 5 apresentam uma correlação moderada. O escore LARS foi capaz de discriminar sintomas com pior qualidade de vida em pacientes submetidos a radio- e quimioterapia pré-operatória. Conclusões: O questionário LARS foi traduzido corretamente para o português europeu, demonstrando alta validade de construto e confiabilidade. Trata-se de uma ferramenta precisa, reproduzível, simples, clara e fácil de usar para avaliar a função intestinal em pacientes com câncer retal após operações poupando o esfíncter. Keywords: Rectal neoplasms, Bowel dysfunction, Low anterior resection syndrome score, Quality of life, Validation, Palavras-chave: Neoplasias retais, Disfunção intestinal, Escore da síndrome da ressecção anterior baixa, Qualidade de vida, Validaçã

Translation and international validation of the Colostomy Impact score.

AIM: Optimal oncological resection in cancers of the lower rectum often requires a permanent colostomy. However, in some patients a colostomy may have a negative impact on health-related quality of life (HRQoL). The Colostomy Impact (CI) score is a simple questionnaire that identifies patients with stoma dysfunction that impairs HRQoL by dividing patients into 'minor' and 'major' CI groups. This aim of this study is to evaluate construct and discriminative validity, sensitivity, specificity and reliability of the CI score internationally, making it applicable for screening and identification of patients with stoma-related impaired HRQoL. METHOD: The CI score was translated in agreement with WHO recommendations. Cross-sectional cohorts of rectal cancer survivors with a colostomy in Australia, China, Denmark, the Netherlands, Portugal, Spain and Sweden were asked to complete the CI score, the European Organization for Research and Treatment of Cancer (EORTC) quality of life 30-item core questionnaire, the stoma-specific items of the EORTC quality of life 29-item colorectal-specific questionnaire and five anchor questions assessing the impact of colostomy on HRQoL. RESULTS: A total of 2470 patients participated (response rate 51%-93%). CI scores were significantly higher in patients reporting reduced HRQoL due to their colostomy than in patients reporting no reduction. Differences in EORTC scale scores between patients with minor and major CI were significant and clinically relevant. Sensitivity was high regarding dissatisfaction with a colostomy. Regarding evaluation of discriminative validity, the CI score relevantly identified groups with differences in HRQoL. The CI score proved reliable, with equal CI scores between test and retest and an intraclass correlation coefficient in the moderate to excellent range. CONCLUSION: The CI score is internationally valid and reliable. We encourage its use in clinical practice to identify patients with stoma dysfunction who require further attention.RD&E staff can access the full-text of this article by clicking on the 'Additional Link' above and logging in with NHS OpenAthens if prompted.Accepted version (12 month embargo